Powerhouse Internship Application
Contact Information
Please enter the following information so that we may get in touch with you.
First Name *
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Last Name *
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Street Address
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City *
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State *
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Zip Code *
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Phone *
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Alternate Phone
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Email Address *
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Educational Background
School Currently Attending *
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Current Grade / Year *
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Major or Area of Interest
If you are in college, what is your major or area of interest? If not in college, you can leave this question blank.
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Reason for Applying *
Why are you interested in The Powerhouse Internship Program?
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Relevant Experience or Qualifications *
Have you participated in any activities or classes, or do you possess any special skills, experience or qualifications which might be relevant to working at the Powerhouse?
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Volunteer and Work Experience *
Please list your volunteer and work experience below.
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Interests, Hobbies, and Extracurricular Activities *
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Desired Length of Participation *
How long do you wish to participate in our internship program?
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References
Please list two references (adults who are not related to you).
Reference #1 Name *
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Reference #1 Relationship *
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Reference #1 Phone *
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Reference #2 Name *
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Reference #2 Relationship *
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Reference #2 Phone *
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Emergency Contact
Please provide information about the person to be contacted in case of an emergency.
Emergency Contact Name *
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Emergency Contact Relationship *
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Emergency Contact Phone *
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Additional Information
Feel free to comment, ask questions, or provide additional information below.
Questions, Comments, Additional Info
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Please Note
As an unpaid intern, you are not covered by The Powerhouse Workers Compensation program. You are urged to have your own health insurance in the event you are injured while performing internship duties.
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This form was created inside of Powerhouse Science Center.